How would you rate your knowledge of the following on a scale of 1 to 10 (10 being the highest)

Food:

Beer:

Wine:

Liquor:

Education

High School:

College/Trade:

Employment History

Current/Most recent employer

Address

Phone number

Position Held

Salary

Dates of employment

Reason for leaving

Supervisor name

May we contact him/her for a reference?

Past employer

Address

Phone number

Position Held

Salary

Dates of employment

Reason for leaving

Supervisor name

May we contact him/her for a reference?

Past employer

Address

Phone number

Position Held

Salary

Dates of employment

Reason for leaving

Supervisor name

May we contact him/her for a reference?

Have you ever pleaded "Guilty", "No contest", or been convicted of a crime?

No

Yes

If yes, give dates and details

Why should we hire you?

I CERTIFY THAT MY ANSWERS ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. I AUTHORIZE YOU TO MAKE SUCH INVESTIGATIONS AND INQUIRIES OF MY PERSONAL, EMPLOYMENT, EDUCATIONAL, FINANCIAL AND OTHER RELATED MATTERS AS MAY BE NECESSARY FOR AN EMPLOYMENT DECISION. I HEREBY RELEASE EMPLOYERS, SCHOOLS OR INDIVIDUALS FROM ALL LIABILITY WHEN RESPONDING TO INQUIRIES IN CONNECTION WITH MY APPLICATION.
IN THE EVENT I AM EMPLOYED, I UNDERSTAND THAT FALSE OR MISLEADING INFORMATION GIVEN IN MY APPLICATION OR INTERVIEW MAY RESULT IN DISCHARGE.